Photo essay: Health care in a slum community in Northeastern Thailand
Inside the life of a Thai Village Health Volunteer who takes care of the underprivileged in a slum community that is both in the center of Khon Kaen City and yet still on the margins of Thai society.
“My life is hard but then I look around and see that other people have it worse than me,” says Ms. Uthumporn. Her budget request letter to the municipality did not ask for much in the way of resources. She knows that the most valuable thing she can offer is her time. Here, she checks to make sure the food that the school donates will not be too spicy for her patients.
Amphon Phosanit used to work transporting and selling vegetables in remote provinces. Five years ago he lost his left arm in a car accident when he swerved to avoid a shipping container that fell off an eighteen-wheel truck in front of him. Now he drives Ms. Uthumporn to the places she volunteers. He earns 50 baht to cover the cost of gas, and 5 Baht for every meal they deliver.
Knocking on the door of each patient's house every day can take a long time, but that closeness is what Ms. Uthumporn thinks makes this program important. “We are closer to each other than we are to doctors. We see the real conditions of the community, but doctors and nurses see the patient only at that moment,” Ms. Uthumporn says.
Ms. Uthumporn smiles, saying “seeing people in the community healthy makes me happy. If I had to choose between helping the community or helping myself, I would help the community.”
Phanom Seemuang, 76, has problems with her vision. Like many of Ms. Uthumporn’s patients, she lives alone and doesn't have family around to take care of her. In the corner of the house, Ms. Phanom has a small stove for cooking on days when Ms. Uthumporn cannot bring her meals.
Ms. Phanom lives here alone. The railroad connecting Nong Khai to Bangkok runs 15 yards outside her front door. Many houses here are dilapidated structures made of plywood and sheet metal, but the community has made some improvements. After petitioning the government to be recognized as a legal settlement, the community was granted legal status ten years ago. Jitti Chertchoo, the headman of Theparak 5 community, says the challenge these days is “the government thinks that children should not be here in the slum.”
Mekhala Nonsiri’s husband works as a gardener in downtown Khon Kaen and her children work at a store, so Ms. Uthumporn helps take care of her during the day. With Ms. Uthumporn’s assistance she is in the process of registering for a disability card and received money to buy a wheel chair. Many of Ms. Uthumporn’s patients receive 800 baht in disability benefits a month from the municipality.
Sustained declines in birth and death rates during the last three decades of the 20th century have left Thailand facing a rapidly growing population of older persons. Almost a third of Thailand’s population will be over the age of 60 by the year 2050. Women constitute the majority of Thailand’s older population and face disadvantages relative to men, including lower levels of literacy, longer periods of widowhood, living alone with significantly lower household income, higher levels of morbidity and disability, and lower likelihood of receiving formal retirement benefits or social security support, according to the United Nations. [Pictured above Ms. Uthumporn visits her patient Amphorn Khanwijit]
Diabetes is a growing problem in Thailand; according to the WHO, one in 13 adult Thais has diabetes. Udom Majundaeng, the president of the VHVs in Theparak 5, does what he can to continue to help the community - such as providing health consultations and helping residents document their conditions - despite his own struggles with the disease.
Basket weaving is a common source of income for the elderly and disabled of Theparak 5. A basket takes a whole day to make and might sell for 50 baht, less than $1.50. For elderly residents living alone, like 75-year-old Samai Moongjuaklang, these baskets are means to a livelihood.
“After I got in the car accident, I didn’t want anyone in my family to take have to care of me, so I moved here to Khon Kaen. I would be a burden to my family and I didn’t want my grandma taking care of me and washing dishes for me - I wanted to take care of myself” Mr. Amphon says. Encouraged by Ms. Uthumporn, Mr. Amphon took up singing. Some nights he can make up to 1,000 baht singing in the market for coins. A true caregiver, Ms. Uthumporn sees the potential in everyone she works with.
Despite living in the center of the city's activities along the rail road tracks, access to public services can be confusing, especially for those not living near extended family.